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ROCHESTER, Minn. — There can be a potential communication barrier between medical providers and deaf or hard-of-hearing patients. Mayo Clinicear, nose and throat expert Colin Driscoll, M.D., is available to discuss the language barrier, including tips for hearing-impaired patients and physicians.

Patients who cannot hear well or who are deaf often require communication assistance for their medical appointments so they and physicians and other health care workers can understand each other and avoid misunderstandings. This is generally through a medical sign language interpreter, computer-aided transcription services, telecommunications devices and written materials.

"There are many patients with significant amounts of hearing loss who really struggle to follow conversations but may not always admit it," Dr. Driscoll says. "Providers often don't recognize it or are unwilling and unable to take the additional time needed to communicate more fully."

Eye contact between the doctor or nurse and the patient is key, says James Cartledge, a Mayo Clinic patient who is deaf.

"Talk directly to the patient because the interpreter will interpret what you are saying," Cartledge says. "I have to look at the interpreter to get the information, but then I look back and forth to the person who's speaking."

Good communication is essential so patients understand critical details about medications and surgeries and other procedures, he adds.

"Deaf or hearing-impaired patients should feel empowered to press for clear explanations from interpreters and physicians and other health care staff, but health care workers should take steps to make sure that good communication is happening in the first place," Dr. Driscoll says.

Dr. Driscoll offers the following tips for health care providers when communicating with the deaf or hearing impaired:

Be aware of any hearing difficulty and have the patient's attention before talking.

Face the patient, slow the rate of speech so there is space between words, and speak clearly.

Reduce background noise, if possible, and if the patient has limited hearing, politely ask whether he or she hears and understands the information.

Type out the discussions with patients and offer them written information about their course of treatment or any other information that is exchanged. Written information is very helpful, even for normal hearing patients, Dr. Driscoll says.

"If providers and the medical system are better educated about the difficulty deaf and hard-of-hearing patients face then there will be less pressure on the patients to advocate for themselves," Dr. Driscoll says. "Providing tools for providers also helps them more easily and effectively communicate reducing the frustration for all."